Publications

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Meyer, J., H. Nsouli-Maktabi, J. B. Spies, S. O. Trerotola, R. E. Pyeritz, B. A. Bernhardt, T. Jahnke, J. P. Schäfer, N. Charalambous, and J. Trentmann, Forthcoming Articles♦ October 2009, , Submitted. Abstract
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2014
Darwish, W. M., S. Darushnia, and W. E. Saad, "Accelerated balloon-occluded retrograde transvenous obliteration without indwelling balloon occlusion for gastric varices with small gastrorenal shunts using a terminal gelfoam plug", American Journal of Roentgenology, vol. 203, issue 2: Am Roentgen Ray Soc, pp. 439-441, 2014. Abstract
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2013
Saad, W. E., A. M. Fischman, G. Frey, D. B. Brown, R. Schenning, S. Kim, S. P. Kalva, S. Dariushnia, C. Wagner, and S. G. Naidu, "9: 04 AM Abstract No. 125-Balloon-occluded retrograde transvenous obliteration (BRTO) utilizing 3% sodium tetradecyl sulfate (STS)(3%) foam for the management of gastric variceal bleeding: a multicenter USA study of 100 patients", Journal of Vascular and Interventional Radiology, vol. 24, issue 4: Elsevier, pp. S62-S63, 2013. Abstract
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Saad, W. E. A., W. M. Darwish, M. G. Davies, S. Kumer, C. Anderson, D. L. Waldman, T. Schmitt, A. H. Matsumoto, and J. F. Angle, "Transjugular intrahepatic portosystemic shunts in liver transplant recipients: technical analysis and clinical outcome", American Journal of Roentgenology, vol. 200, issue 1: Am Roentgen Ray Soc, pp. 210-218, 2013. Abstract
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Saad, E. A. W., W. M. Darwish, and M. G. Davies, "Was bringt der TIPS nach der Lebertransplantation?", Interventionelle Radiologie Scan, vol. 1, issue 01: © Georg Thieme Verlag KG, pp. 32-33, 2013. Abstract
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2011
Saad, W., C. L. Anderson, W. M. Darwish, M. G. Davies, D. L. Waldman, J. F. Angle, U. C. Turba, S. S. Sabri, J. Stone, and T. Kitanosono, "Abstract No. 77: Comparison between the technical results of TIPS in liver transplant recipients and native (non-transplanted) patients", Journal of Vascular and Interventional Radiology, vol. 22, issue 3: Elsevier, pp. S35-S36, 2011. Abstract
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2010
Saad, W. E. A., W. M. Darwish, M. G. Davies, and D. L. Waldman, "Transjugular intrahepatic portosystemic shunts in liver transplant recipients for management of refractory ascites: clinical outcome.", Journal of vascular and interventional radiology : JVIR, vol. 21, issue 2, pp. 218-23, 2010 Feb. Abstract

PURPOSE: To determine the effectiveness of transjugular intrahepatic portosystemic shunt (TIPS) creation in liver transplant recipients with recurrent portal hypertension presenting with refractory ascites.

MATERIALS AND METHODS: A retrospective review of transplant recipients undergoing TIPS creation was performed over a 6-year period. Recipients were noted for age, sex, TIPS indication, Model for End-stage Liver Disease (MELD) score, cause of initial liver disease, and time between first transplantation and TIPS creation. Clinical success was defined as graft survival of longer than 1 month with improvement in ascites. New-onset or worsening encephalopathy was noted. Graft survival and patency were calculated according to the Kaplan-Meier method. MELD score and portosystemic gradient (PSG) before and after TIPS creation were evaluated for prediction of graft loss less than 3 months after TIPS creation.

RESULTS: Nineteen liver transplant recipients underwent TIPS creation for ascites. Mean time from transplantation was 3.5 years (range, 3.7-112.2 months). Mean MELD score before TIPS creation was 17 (range, 7-24). The technical, hemodynamic, and clinical success rates were 100%, 95%, and 16%, respectively. Encephalopathy developed in five patients (26%). Thirty- and 90-day mortality rates were 16% (n = 3) and 21% (n = 4), respectively. Primary unassisted patency and graft survival rates at 1, 3, and 6 months were 100%, 90%, and 90% and 79%, 58%, and 47%, respectively. MELD score parameters were significant indicators (P < .05) for graft survival beyond 3 months, but PSG parameters were not.

CONCLUSIONS: TIPS for the management of ascites in liver transplant recipients is not as clinically effective as it is in patients with native livers (16% vs 50%-80% in the literature). MELD score is a predictor of graft survival; PSG parameters are not.

Saad, W. E., W. M. Darwish, M. G. Davies, and D. L. Waldman, "Abstract No. 65: Transhepatic dilation of anastomotic biliary strictures in liver transplant recipients: A comparison between a conventional balloon protocol vs. a combined cutting-conventional balloon protocol", Journal of Vascular and Interventional Radiology, vol. 21, issue 2: Elsevier, pp. S26-S27, 2010. Abstract
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Darwish, W. M., W. E. Saad, M. G. Davies, D. Butani, and D. L. Waldman, "Abstract No. 85: Transjugular intrahepatic portosystemic shunts in liver transplant recipients for management of refractory ascites: Clinical outcome", Journal of Vascular and Interventional Radiology, vol. 21, issue 2: Elsevier, pp. S34, 2010. Abstract
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Saad, W. E. A., W. M. Darwish, M. G. Davies, and D. L. Waldman, "Transjugular intrahepatic portosystemic shunts in liver transplant recipients for management of refractory ascites: clinical outcome", Journal of Vascular and Interventional Radiology, vol. 21, issue 2: Elsevier, pp. 218-223, 2010. Abstract
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2009
Saad, W. E. A., L. G. Sahler, K. E. Westesson, P. F. Della Pietra, W. M. Darwish, T. Kitanosono, and D. L. Waldman, "Dual-tract Transhepatic U-shaped Hemodialysis Inferior Vena Cava Catheter: A Feasibility Study in a Swine Model", Journal of Vascular and Interventional Radiology, vol. 20, issue 12: Elsevier, pp. 1625-1631, 2009. Abstract
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